NIOSH Revises Resource on Respiratory Protection Programs for Healthcare Workers

April 25, 2022
NIOSH recently published a revised version of an agency resource intended to help hospitals implement effective respiratory protection programs. Titled Hospital Respiratory Protection Toolkit: Resources for Respiratory Program Administrators, this resource was originally published in 2015 and emphasizes the prevention of aerosol disease transmission to healthcare workers. According to NIOSH’s website, the new edition includes contextual changes to the document’s wording that “reflect newer health and safety guidance since the publication of the original toolkit,” as well as routine edits and updated hyperlinks and references to other resources.
Healthcare workers often take on health and safety responsibilities in facilities that have limited resources, the toolkit’s introduction explains. Accordingly, the NIOSH resource is “written as a practical manual that can be used by anyone charged with setting up and maintaining a hospital respiratory protection program.” The toolkit explains why healthcare facilities must implement respiratory protection programs and controls; lists different kinds of respiratory protection; outlines the development of a respiratory protection program; and provides a respiratory protection program template.
A free PDF of the toolkit can be downloaded from the NIOSH website.
U.S. Department of Labor Emphasis Program Seeks to Identify, Reduce Silica Dust Hazards in Denver’s Cut Stone, Stone Products Industry
OSHA developed a new Regional Emphasis Program to identify and reduce hazards in the cut stone and stone products industry. Enforcement will begin on May 17, 2022. In the past 10 years, the cut stone and stone products manufacturing industry has had the highest documented overexposures to respirable crystalline silica in the region. 
Focused on getting industry employers to follow required safety standards and alert workers to silica hazards, the emphasis program addresses struck-by and crushing hazards for handling of granite, marble, limestone, slate and other stone slabs.  
“This Regional Emphasis Program on silica addresses serious health and safety hazards and enhances our focus on ensuring that industry employers comply with OSHA requirements,” said OSHA Regional Administrator Jennifer Rous in Denver. “Inhaling elevated levels of respirable crystalline silica without proper protection increases the risk of contracting multiple diseases, including silicosis, an incurable lung disease that can lead to disabling or fatal injuries.”
Prior to initiating the REP, OSHA provided outreach assistance to industry employers and employee groups as part of an ongoing effort to help employers and workers identify and eliminate common hazards in this industry. 
Crystalline silica is a common mineral found in sand, concrete, natural stone, artificial stone, mortar and other materials, and generates respirable dust during cutting, grinding and polishing processes. In the past decade, OSHA found 30 percent of the documented overexposures in the region occurred in the cut stone and stone products industry.
EPA to Step Up Federal Actions in Pennsylvania for Water Pollution
After the EPA reviewed Pennsylvania’s updated plan to address pollution reduction goals for the Chesapeake Bay watershed, it found that the plan falls short of those goals largely due to the lack of resources provided by the state. Approximately 25,000 miles of streams in the state – more than the Earth’s circumference – are considered unsuitable for fishing, recreation or other uses. 
Pennsylvania’s draft amended Phase III Watershed Implementation Plan (WIP) meets 70 percent of its nitrogen reduction target – 9.7 million pounds short, the EPA evaluation found. Much of this is attributed to uncontrolled manure runoff into streams, although there are other contributing pollution sources.  
“Pennsylvania has made noteworthy progress in recent years and key partnerships are in place,” said EPA Mid-Atlantic Regional Administrator Adam Ortiz. “State agencies, counties, farmers, partners and nonprofits are on board and have put in a tremendous effort. What’s missing are improved manure control policies and dependable state funding for agriculture cost-share programs for farmers. These are measures other states have had for a long time.” 
Pennsylvania will now have 90 days to submit an improved final plan that meets its targets. Starting this week, EPA will be taking stronger actions statewide to promote clean-up progress, such as increased agriculture and municipal stormwater inspections, increased permit oversight, heightened enforcement actions and a redirection of certain federal funds to ensure they are spent more efficiently in Pennsylvania. 
“Enhanced inspections and enforcement are a last resort, but that is where we are. Governor Wolf and legislative leaders have key proposals on the table in Harrisburg that would make a big difference,” said Ortiz, “We may live in different states in this region, but the rivers are shared by all, and each needs to do their part.” 
Study Reveals Suncor PFAS Pollution in Surface Water and Municipal Drinking Water Systems
A new study conducted by Westwater Hydrology LLC connects PFAS pollution in Sand Creek and the South Platte River, as well as river water used by Commerce City, Brighton, Thornton, Aurora, and other municipal drinking water systems, to the Suncor refinery in Denver. The study found that Suncor’s 2021 discharges from just one outfall, 020, account for 16-47% of the total PFAS loading in Sand Creek and 3-18% of the total PFAS loading in the South Platte.
Municipalities, including Commerce City, Brighton, Thornton, and Aurora, utilize water intake wells along the South Platte downstream of Suncor. Due to the hydrology of the river and the underlying aquifer, any PFAS in the river gets drawn into the drinking water system when it enters these intake wells. The South Platte is also a major source of agricultural irrigation water; Suncor’s PFAS pollution is likely taken up by crops, creating another exposure point for the humans and animals that consume them.
“The communities surrounding the refinery have faced disproportionate health impacts and threats from Suncor for far too long,” said Caitlin Miller, senior associate attorney with Earthjustice’s Rocky Mountain office. “This facility continues to pollute the air that people breathe and the water that they drink with relative impunity. It is time for the Colorado Department of Public Health & Environment (CDPHE) to issue the strongest possible water discharge permit that prohibits Suncor from discharging any more PFAS.”
The PFAS levels studied at Outfall 020 do not account for additional pollution from Suncor’s other outfalls, including process water and stormwater outfalls, which only add to the overall impacts to Colorado’s waterways and drinking water.
CDPHE’s Water Quality Control Division has put forth a draft water permit that reduces the amount of PFAS that Suncor can discharge but fails to limit it to levels that are safe. Suncor installed a temporary treatment system in October 2021 to reduce its PFAS discharges at Outfall 020, but even with these measures in place, the pollution remains at toxic levels according to updated toxicity assessments from the Agency for Toxic Substances and Disease Registry (ATSDR) and the EPA.
In its initial comments on the draft permit, Suncor requested that CDPHE dramatically weaken the pollution limits and monitoring requirements in its final permit for multiple pollutants, including PFAS.
“We have endured pollution to our sources of life through environmentally-racist policies in Commerce City for so long without restoration that even state and federal agencies have normalized trauma to our communities without protection or regulation from extractive industries,” said Renée Millard-Chacon, co-founder and executive director of Womxn from the Mountain, an Indigenous Womxn-led nonprofit based out of Commerce City. “However, we are all connected, and it is never okay to harm disproportionately impacted communities this way, including our future generations, without respecting our right to live and thrive without severe environmental degradation for an economic gain that has never benefited residents’ health.”
PFAS are toxic pollutants that persist in our bodies and the environment for decades. Drinking water is one of the most common routes of exposure to PFAS. Studies of the best-known PFAS have shown links between the chemicals and kidney and testicular cancer, as well as endocrine disruption in people.
The EPA recently objected to Suncor’s draft Title V air permit, finding that CDPHE failed to scrutinize changes to the company’s operations, including those that allow the company to emit even more harmful pollution into surrounding communities. EPA’s objection directs CDPHE to no longer rubberstamp proposed changes to the refinery’s operations.
Contractor Cited After Fatal Incident
A federal investigation into how a 47-year-old carpenter was fatally injured on Oct. 6, 2021, at the Pinellas Gateway Express project in Clearwater found his employer violated safety standards by allowing workers to remain in a crane load’s danger zone.
The incident occurred as the employee of Archer Western – De Moya JV II, along with five other employees, worked inside a trench box cutting concrete piles used to build footers for elevated lanes of the expressway.
OSHA determined Archer Western failed to follow required safety standards and provide adequate training and supervision while workers used a gas-powered chop saw to cut concrete piles. Inspectors determined that the concrete pile was attached to a crane with a damaged wire rope sling. During the cutting, the pile broke free and struck the worker in the chest, pinning him against the wall.
“Archer Western could have prevented this tragic incident if they had taken the necessary steps to identify and mitigate safety hazards,” said OSHA Area Office Director Danelle Jindra in Tampa, Florida. “Workers deserve to start each workday without worrying whether they will return home unharmed. Employers have an obligation to follow safety standards to protect their workers from all known hazards.”
OSHA investigators cited Archer Western – De Moya JV II for exposing workers to struck-by and crushed-by hazards due to:
  • Allowing workers to remain within the danger zone while tension was applied to a crane’s load in direct contravention of the crane manufacturer’s procedures
  • Failing to train workers on how to recognize and avoid unsafe working conditions and train or qualify the signal person prior to directing crane operation
  • Failing to ensure hand signals between the crane operator and the signal person were agreed upon before conducting a lift
  • Using a wire rope sling with damaged capacity information tags
The agency proposed $60,084 in penalties.
Archer Western – De Moya JV II is a joint-venture between Chicago’s The Walsh Group, its subsidiary Archer Western of Atlanta, and The De Moya Group Inc. of Miami. The Florida Department of Transportation Pinellas Gateway Expressway is one of the largest Tampa Bay area construction projects to-date. The two-part project consists of constructing two new two-lane elevated tolled roadways that will provide direct connections between U.S. 19 and I-275 and between the Bayside Bridge north of 49th Street North and I-275 in Pinellas County.
Illinois Contractor Exposed Roofing Workers to Deadly Fall Hazards
A Waukegan contractor – with a history of violating federal safety standards and ignoring safety citations – was cited again by OSHA for exposing workers to deadly fall hazards at two separate job sites in October 2021. Joshua Herion – who does business as ECS Roofing Professionals, Inc. – faces proposed penalties of $360,531.
An OSHA inspector observed a foreman and two roofers atop a Hoffman Estates commercial building working at heights of up to 20 feet off the ground with inadequate fall protection. Just 10 days later, an OSHA inspector observed a crew of three working at heights greater than 12 feet atop a residential building in Waukesha, Wisconsin, without fall protection equipment.
OSHA found ECS Roofing Professionals failed to equip workers with adequate fall protection equipment, train workers on its use, provide safe access to a ladder jack scaffold platform and ensure head and eye protection were used. The agency issued one willful, four repeat and eight serious violations.
“In both of these incidents, the foreman left the site and directed others to do so when OSHA inspectors began asking questions about their safety procedures. This defiant act demonstrates Joshua Herion and his company’s disregard for the safety and well-being of workers and the law,” said OSHA’s Chicago North Area Director Angeline Loftus in Des Plaines, Illinois, who investigated the Hoffman Estates job site. “Fall hazards make roofing work among the construction industry’s most dangerous jobs and among OSHA’s most frequently cited safety hazards.”
The pair of recent inspections continues the company’s history of failing to protect its roofing workers. Since 2014, ECS Roofing Professionals has been cited seven times by OSHA for similar hazards at other job sites. The employer has failed to respond to OSHA’s requests for information, has not responded to citations from previous inspections and has had $139,656 in unpaid OSHA penalties referred to debt collection.
“While ECS Roofing Professionals seem willing to ignore the dangers of falls and the potential for serious injuries or worse, OSHA will hold Joshua Herion and other roofing contractors accountable for failing to meet the legal requirements to provide safe working conditions,” said OSHA’s Area Director Christine Zortman in Milwaukee, who investigated the Waukesha job site. “Fall injuries and fatalities are preventable with the proper use of safety equipment and training.”
The Bureau of Labor Statistics reports that in 2020, 1,008 construction workers died on the job, with 351 of those fatalities due to falls from elevation.
OSHA’s stop falls website offers safety information and video presentations in English and Spanish to teach workers about hazards and proper safety procedures. Learn more about OSHA’s annual National Safety Stand-Down to Prevent Falls, set for May 2-6.
U.S. Department of Labor Announces Proposal to Reconsider, Revoke Final Approval of Arizona's State OSHA Plan After Pattern of Failures
The U.S. Department of Labor recently announced a proposal to reconsider and revoke the final approval of Arizona's State OSHA plan, in response to nearly a decade-long pattern of failures to adopt and enforce standards and enforcement policies at least as effective as those used by OSHA.
State plans are OSHA-approved job safety and health programs operated by individual states rather than federal OSHA. The OSH Act encourages states to develop and operate their programs. OSHA approves and monitors all state plans and provides up to 50 percent of each program's funding.
OSHA has grown increasingly concerned that actions by the Arizona State OSHA Plan suggest the state is either unable or unwilling to maintain its commitment to provide a program for worker safety and health protection as the OSH Act requires. Arizona has, for example, failed to adopt adequate maximum penalty levels, occupational safety and health standards, National Emphasis Programs and – most recently – the COVID-19 Healthcare Emergency Temporary Standard.
If OSHA determines that a state plan is failing to comply with its obligation to remain at least as effective as OSHA, the agency may initiate proceedings to revoke final approval, and reinstate federal concurrent authority over occupational safety and health issues covered by the state plan.
The proposal is available for public inspection at the Federal Register, and will be published on April 21. With its publication, OSHA marks the start of the revocation process. The notice makes no substantive changes to the Arizona State Plan, nor does it give federal OSHA the authority to enforce occupational safety and health standards in Arizona.
Submit comments on the proposal by May 26, 2022. If necessary, OSHA will hold an online hearing on Aug. 16, 2022, at 10 a.m. EDT. Those interested in testifying or questioning witnesses must submit a notice of their intention by May 11, 2022.
Once OSHA has considered comments during the 35-day comment period, and reviewed testimony and evidence collected in the event of a hearing, the agency will publish a second Federal Register notice announcing its decision on revocation of final approval.
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